REGIONAL  IODINE 
THERAPY 


SF855 
155 
S74 
1919 


®t|p  i.  M.  Ml  iCibrarg 

Nnrtlj  (Earaltna  g>talF 


•=« 


This  book  was  presented  by 

MILTON  M.  LEONARD,  D.V.M. 

TO  THE 

VETERINARY  MEDICAL  LIBRARY 


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150M/01-92— 920179 


A  Treatise 

on 

Regional  Iodine 
Therapy 

for 

The  Veterinary  Clinician 

by 
MART  R.  STEFFEN,  M.D.C.,  V.S. 

Author   of   Special   Veterinary    Therapy, 

Special     Cattle     Therapy,     Clinical 

Diagnosis  of  Cattle  Diseases, 

Special  Equine  Therapy, 

Veterinary  Clinical 

Notes,  etc. 


1919 


Published  by 

Pharmacal  Advance  Publishing  Co. 

i68  Duane  Street,  New  York 


Copyright   1919  by 
Pharmacal  Advance  Publishing  Co. 


CONTENTS. 


I.  Introduction. 

II.  General  Considerations  of  Local 
Iodine  Therapy. 

III.  Special  Considerations  of  Local 
Iodine  Therapy. 

IV.  The  Selection  of  Iodine  Prepara- 
tions for  Practical  Use. 

V.  Method  of  using  Regional  Iodine 
Therapy  in  the  Correction  of 
Various  Pathological  Conditions. 


Introduction. 

In  presenting  to  the  veterinary  pro- 
fession this  treatise  on  Regional  Iodine 
Therapy,  I  do  so  with  the  object  of 
bringing  into  the  Hght  certain  cHnical 
facts  that  have  to  do  with  the  topical 
application  of  iodine  in  veterinary  pa- 
tients, and  to  discuss,  from  the  stand- 
point of  the  clinician,  those  particular 
pathological  conditions  to  which  these 
facts  apply. 

It  will  be  further  my  purpose  to 
point  out  to  the  reader  the  special  indi- 
cations for  topical  iodine  medication 
which  have,  in  the  past,  been  over- 
looked by  the  practitioner  of  veterinary 

medicine. 

5 


Throughout  the  treatise  I  shall  con- 
fine myself  to  the  exposition  of  only 
such  matter  as  I  have  found  to  be  com- 
patible with  the  practical  phases  of 
veterinary  science  in  the  conduct  of  my 
own  practice. 

M.  R.  S. 
Milwaukee,  Wis. 
March,  19 19. 


11. 


General  Considerations  of  Local 
Iodine  Therapy. 

While  it  is  a  fact  that  iodine  is  one 
of  the  most  popular  of  the  many  medic- 
inal agents  used  by  the  practitioner  of 
veterinary  medicine  and  surgery,  it  al- 
so is  a  fact  that  iodine — more  so  than 
any  other  agent — is  frequently  used  in 
pathological  conditions  and  under  cir- 
cumstances that  lack  every  scientific 
indication  for  its  application.  To  a 
certain  extent  this  is  true  of  almost  any 
medicinal  agent  in  common  use,  even 
those  whose  field  of  applicability  is  less 
broad  than  that  of  iodine;  but  it  is  es- 
pecially noteworthy  in  the  use  of  iodine. 

Iodine  does  not  differ  from  any  other 
therapeutic  agent  with  regard  to  indi- 
vidual indications  for  its  application; 
it  has  these  as  prominently  marked  as 
have  the  alkaloids,  physiologically. 
7 


But  it  does  differ  from  almost  all  other 
therapeutical  agents  in  the  fact  that,  it 
has  such  a  vast  field  of  applicability  in 
which  the  indications  for  its  use  are 
supported  solely  by  clinical  evidence 
and  in  which  its  action  defies  all  at- 
tempts at  an  explanation  of  results  at- 
tained, on  a  physiological  basis. 

Although  the  practitioner  may  not 
be  able  to  satisfy  his  ethical  desire  to 
explain  the  action  of  preparations  of 
iodine  in  the  latter  class  of  pathological 
conditions,  he  soon  makes  the  discovery 
that  these  actions  and  results  are,  to  a 
very  considerable  degree,  dependent 
upon  more  or  less  well-marked  clinical 
and  physical  phenomena.  In  order  to 
be  able  to  give  to  his  use  of  iodine,  in 
its  various  forms,  even  a  semblance  of 
ethical  practice,  and,  also,  in  order  to 
be  able  to  roughly  classify  and  select 
the  conditions  in  which  he  may  use 
iodine  with  some  expectation  of  uni- 
8 


form  results,  it  becomes  imperative  that 
the  practitioner  acquaint  himself  with 
these  facts  and  phenomena.  Not  only 
this,  but  he  must  acquaint  himself,  as 
well,  with  the  peculiar  and  individual 
effects  and  actions,  in  a  clinical  sense, 
of  the  different  forms  in  which  iodine 
is  used  as  a  topical  or  regional  appli- 
cation. 

What  may  be  an  indication  for  the 
use  of  iodine  in  one  form,  may  lack  the 
requisite  pathological  status  for  its  ap- 
plication in  a  successful  manner  in  one 
of  its  other  forms.  Thus,  in  a  given 
pathological  condition,  an  ointment  of 
iodine  may  fall  far  short  of  the  thera- 
peutic power  that  the  practitioner  ex- 
pects it  to  exert,  despite  the  fact  that 
the  case  is  clearly  one  for  iodine  ther- 
apy. When,  on  the  other  hand,  in  the 
same  case,  use  is  made  of  the  tincture 
of  iodine,  or  of  an  aqueous  solution  of 
iodine,  the  desired  results  may  be  ob- 
9 


tained  with  almost  amazing  prompt- 
ness. Again,  in  another  class  of  cases, 
the  reverse  may  be  true. 

Although,  in  a  goodly  proportion  of 
the  cases  to  be  discussed  in  the  follow- 
ing chapters  in  this  treatise,  the  prac- 
titioner must  come  into  direct  and  fre- 
quent clinical  contact  with  the  patho- 
logical conditions  themselves  in  order 
to  become  thoroughly  acquainted  with 
the  clinical  and  physical  facts  referred 
to,  he  will  derive  much  benefit  from  a 
careful  reading  of  these  chapters,  to 
the  extent  that  he  will  note  not  only 
new  lines  of  thoueht  with  regard  to 
iodine  medication,  but  he  may  also  lay, 
in  their  reading,  the  foundation  for  an 
ethical  system  of  iodine  therapy  in  so 
far  as  this  is  possible  in  the  light  of 
our  present  acquaintance  with  the  sub- 
ject. 


10 


III. 


Special  Considerations  of  Local 
Iodine  Therapy. 

When  we  undertake  the  considera- 
tion of  those  features  of  iodine  therapy 
which  have  to  do  with  its  adaptabiHty 
to  definite  remedial  ends,  we  enter  upon 
a  field  of  thought  that  may  take  several 
forms. 

We  are  concerned,  in  this  treatise, 
only  with  matter  relating  to  regional, 
topical,  or  local  applications  of  the 
agent  under  discussion,  and  we  can 
well  begin  the  consideration  with  the 
identification  of  the  agent  itself  and 
the  different  forms  under  which  it  is 
most  commonly  used.  For  all  practical 
purposes,  we  can  confine  the  discussion 
of  the  agent  itself  to  that  of  the  four 
forms,  or  preparations,  of  iodine  in 
almost  universal  use  by  practitioners  of 
veterinary  medicine  and  surgery. 
11 


When,  in  veterinary  medicine,  allusion 
is  made  to  iodine,  it  is  almost,  without 
exception,  to  one  of  the  following 
preparations : 

1.  Tincture  of  Iodine. 

2.  Ointment  of  Iodine. 

3.  Aqueous  solutions  of  Iodine. 

4.  Oily  solutions  or  mixtures  of  Io- 
dine. 

Only  in  rare  cases,  and  then  under 
specific  reference,  is  iodine  used  in 
other  forms,  or  in  its  elemental  state, 
in  veterinary  medicine.  Iodine  is  a 
very  active  agent,  chemically  as  well 
as  therapeutically,  and  is  not  readily 
compatible  with  other  agents.  It  is  for 
this  reason,  that  combinations  of  iodine 
with  other  drugs  and  chemicals  are  not 
common,  and  therein  lies  a  distinction 
for  iodme  that  not  many  other  thera- 
peutic agents  can  claim;  namely,  that 
beneficial  effects  resulting  from  iodine 
medication  are  almost,  without  ques- 
12 


tion,  due  to  it  alone;  it  is  hardly  ever 
applied  in  combination  with  synergists 
which  might  obscure  the  activity  of  in- 
dividual ingredients. 

This  remarkable  therapeutic  activity 
of  iodine  is  such  that,  when  properly 
applied  in  some  of  its  forms,  its  pres- 
ence can  be  demonstrated  in  the  under- 
lying tissues.  After  prolonged  courses 
of  topical  application,  its  action  is  oc- 
casionally appreciated,  both  subjectively 
and  objectively,  in  the  evidence  of  more 
or  less  clearly  defined  constitutional  or 
systemic  indications  of  its  presence 
within  the  animal  organism. 

From  this,  it  is  apparent  that,  in  io- 
dine preparations  of  a  particular  class, 
we  have  an  agent  whose  topical  reme- 
dial effects  are,  in  some  slight  measure, 
due  to  systemic  action ;  in  part  at  least, 
this  action  being  the  effect  of  great 
physiological  activity  exdrted  in  the 
limited  area  of  its  topical  application. 
13 


In  some  degree  this  activity  of  certain 
preparations  of  iodine  can  be  explained 
by  reference  to  the  chemical  properties 
inherent  in  iodine  as  elemental  matter, 
and  in  its  well-known  affinity  for  cer- 
tain elemental  constituents  of  the  tis- 
sues of  the  animal  organism. 

The  foregoing  throws  some  light  on 
the  therapeutic  accomplishments  of  io- 
dine preparations,  when  topically  ap- 
plied, and,  to  a  certain  extent,  explains 
its  modus  operandi  in  a  physiological 
sense — an  understanding  somewhat  es- 
sential from  an  ethical  standpoint.  The 
old  theory,  which  would  ascribe  to  an 
increase  in  function  of  the  regional 
lymphatic  glands  all  the  agreeable 
therapeutic  effects  of  local  iodine  ap- 
plications, does  not  cover  enough 
ground;  it  is  only  when  we  amplify 
this  theory,  with  the  assumption  of  the 
considerations  aired  in  the  foregoing 
paragraphs,  that  we  find  it  possible  to 
14 


attain  a  clear  understanding  of  the 
physiological  action  of  iodine  prepara- 
tions applied  regionally. 

The  Clinical  Aims  for  topical  therapy 
are  to  be  classified  as  follows : 

1.  Prophylactic. 

2.  Ameliorative. 

3.  Curative. 

Under  these  three  heads,  we  further 
sub-classify  the  actual  clinical  condi- 
tions, which  are  indicated,  into  the  fol- 
lowing : 

Under  i.  Surgical  preparatory  tech- 
nique. 

Under  2.  Acute  pathological  condi- 
tions, in  the  corrections  of 
which  topical  applications 
of  iodine  preparations  are 
used  as  an  adjunct  to  in- 
ternal medication  with 
other  agents. 
15 


Under  3.   Chronic  pathological  con- 
ditions,  in  which  one  or 
more    of    various    iodine 
preparations,    locally    ap- 
plied, constitutes  the  en- 
tire treatment. 
This  classification  and  sub-classifica- 
tion is  important  and  essential  when  we 
endeavor  to  make  our  use  of  iodine  con- 
form  to  ethical   standards;    it   is   also 
very  essential  to  the  attainment  of  cer- 
tain therapeutic  ends  in  actual  practice. 

I.  The  Local  Application  of  Prep- 
arations OF  Iodine  in  the  Sense 
OF  Prophylactic  Aim  in  Surgery. 

The  exhaustive  pre-operative  wash- 
ing and  scrubbing  of  the  integument, 
that  veterinary  practitioners  applied  to 
their  surgical  patients  in  years  past,  has 
given  way  almost  entirely  ~v  iodine 
painting.  Even  those  surge  r,ns  who 
still  adhere  to  the  scrubbing  and  wash- 
ing of  the  parts  about  to  be  incised, 
16 


complete  the  process  with  an  appUca- 
tion  of  iodine  thereafter. 

An  application  of  iodine  to  the  skin 
covering  the  region  that  is  about  to  be 
invaded  by  the  knife  of  the  surgeon,  has 
been  found  much  more  efficacious  and 
much  more  reliable  than  has  the  wash- 
ing and  the  scrubbing  with  antiseptic 
solutions,  soaps  and  other  agents.  Not 
only  this,  but  it  has  also  greatly  sim- 
plified and  shortened  an  otherwise  te- 
dious, prolonged  and  sloppy  technique. 
Whereas,  the  surgeon  formerly  spent 
from  fifteen  minutes  to  half  an  hour 
scrubbing  and  washing  the  field  of 
operation,  he  now  applies  a  few  coats  of 
iodine  tincture — a  few  strokes  of  the 
swab  or  brush — and  it  is  done. 

This    simplified    technique    has    the 
added  advantage  of  the  total  elimina- 
tion of  basins,  brushes,  and  sponges  for 
use   in   the   preliminary   stages   of   an 
17 


operation,  as  well  as  the  agreeable  ab- 
sence of  the  wet,  sloppy  field  that  in- 
evitably resulted  from  the  use  of  the 
older  method  in  veterinary  practice. 
Besides,  it  spares  the  patient  in  more 
ways  than  one,  especially  in  the  cold 
months  of  the  year  when,  in  a  veteri- 
nary practice,  operations  frequently 
have  to  be  performed  in  cold  stables, 
or  even  in  the  open. 

While  the  application  of  tincture  of 
iodine  gives  ample  protection  from  skin 
infection  in  surgical  operations,  there 
are  a  few  things  to  be  observed  that 
have  to  do  with  making  the  application 
correctly.  First,  in  veterinary  patients, 
the  hair  must  be  clipped  off  and  the 
area  shaved  clean.  The  area  clipped 
and  shaved  should  be  slightly  greater 
in  extent  than  the  field  actually  to  be 
invaded  by  the  knife.  When  the  clip- 
ping and  shaving  have  been  done,  the 
18 


area  should  be  lightly  brushed  with  a 
stiff,  dry  brush,  in  order  to  remove 
dandruff  and  scurf. 

The  second — and  the  most  important 
— point  is  that  the  surface  that  is  to 
be  painted  with  the  tincture  of  iodine 
be  perfectly  dry.  In  the  event  that  the 
area  to  be  painted  should  contain  a  de- 
posit of  filth,  oily  or  greasy  in  nature, 
this  should  first  be  removed  by  swab- 
bing and  wiping  with  gauze  or  cotton 
saturated  with  gasoline,  benzine  or 
ether;  these  remove  oily,  greasy  or 
fatty  filth  and  evaporate  quickly,  leav- 
ing the  area  perfectly  dry  and  clean. 
Washing  with  watery  solutions,  previ- 
ous to  the  iodine  application,  is  not  re- 
commended under  any  conditions. 

When  the  area  has  been  clipped, 
shaved,  freed  from  grease  or  other 
filth,  and  then  allowed  to  become  per- 
fectly dry,  the  tincture  of  iodine  is 
applied  liberally  with  a  soft  brush,  or 
19 


with  a  cotton  swab.  This  is  allowed  to 
dry  for  a  minute  or  two;  another  ap- 
plication is  then  made  directly  on  top 
of  the  first  one,  allowed  to  evaporate  to 
dryness,  and  the  field  is  ready  for  the 
incision. 

As  iodine  readily  attacks  metals,  and 
spoils  the  plating  on  instruments,  no 
instrument  should  be  allowed  to  come 
in  contact  with  the  painted  area  while 
it  is  still  moist;  neither  should  the  io- 
dine be  used  for  disinfecting-  purposes 
on  any  utensils  or  apparatus  made  of 
metal.  The  fact  that  the  iodine  may 
injure  instruments  can  not  be  consid- 
ered in  the  light  of  a  disadvantage,  if 
the  above  precautions  are  taken. 

Another  practice  that  has  come  to 
be  recognized  quite  generally  among 
surgeons  is  that  of  painting  the  edges 
of  the  surgical  wound  with  pure  tinc- 
ture of  iodine  just  before  the  wound 
is  to  be  closed  with  sutures.  Whether 
20 


this  is  good  practice,  on  general  prin- 
ciples, is  a  matter  that  is  open  to  debate. 
If  the  painting  is  done  carefully,  so 
that  a  pool  of  iodine  tincture  is  not 
formed  by  the  surplus  gathering  by 
gravitation  into  the  deeper  recesses  of 
the  wound,  this  may  be  considered 
good  practice.  On  the  whole,  how- 
ever, it  would  appear  that  the  iodine 
could  act,  in  many  instances,  as  an  un- 
desirable irritant  when  it  comes  in  con- 
tact with  delicate,  freshly  incised  tis- 
sues. 

As  the  object,  in  modern  surgery,  is 
to  eliminate  all  things,  even  the  slight- 
est, that  may  hinder  prompt  repair  and 
smooth  healing  of  the  invaded  tissues, 
the  presence  of  such  an  active  agent  as 
pure  tincture  of  iodine  in  a  surgical 
wound  may  be  looked  upon  as  inter- 
fering with  the  carrying  out  of  that 
object. 


On  the  other  hand,  in  surgical 
wounds  of  an  already  infected  charac- 
ter in  which  primary  union  would  be 
out  of  the  question,  the  application  of 
pure  tincture  of  iodine,  in  liberal 
amounts,  can  not  be  too  highly  en- 
dorsed. 

The  latter  statement  applies,  with 
even  greater  force,  to  all  wounds  of  an 
accidental  character  in  the  fleshy  por- 
tions of  the  anatomy. 

It  is  also  the  practice  of  many  veteri- 
nary surgeons  to  apply  pure  tincture  ot 
iodine  to  the  wound  after  the  sutures 
have  been  put  into  place.  This  is  a 
very  satisfactory  practice,  if  the  paint- 
ing is  done  gently  and  not  too  freely. 
An  excess  of  the  tincture  of  iodine — 
if  the  wound  edges  have  not  been  co- 
apted  perfectly — may  result  in  cause 
for  stitch  abscess  when  a  considerable 
amount  of  the  iodine  becomes  pocketed 
22 


in  some  part  of  the  wound  under  the 
Hne  of  suture. 

In  certain  animals,  whose  skins  are 
very  tender,  the  local  application  of 
pure  tincture  of  iodine,  previous  to  sur- 
gical incision,  is  followed,  in  a  few 
days,  by  slight  peeling  of  the  integu- 
ment. This  is  so  rare  an  occurrence, 
however,  and  of  so  little  consequence, 
that  it  need  not  be  considered,  and  can 
not  be  looked  upon  as  a  drawback  to 
this  otherwise  salutary  practice. 

Aside  from  its  use  in  the  preparation 
of  the  surgical  field,  tincture  of  iodine 
is  also  used,  in  a  prophylactic  sense,  to 
prepare  the  skin — in  a  similar  manner 
— for  the  entrance  of  the  hypodermic 
needle  whenever  a  subcutaneous  injec- 
tion is  to  be  made.  It  is  not  practical, 
nor  necessary,  in  this  instance,  to  shave 
away  the  hair;  the  site  that  has  been 
selected  for  the  needle  puncture  is 
merely  painted  liberally  with  the  iodine. 
23 


As  in  the  case  of  a  surgical  incision 
area,  so  also  here,  the  parts  to  which 
the  application  is  made  must  be  per- 
fectly dry. 

2.  The  Use  of  Iodine  as  an  Ad- 
junct TO  Internal  Medication 
IN  THE  Correction  of  Acute 
Pathological  Conditions. 

Iodine  preparations  of  various  forms 
are  very  commonly  used  topically  as  an 
an  adjunctive  treatment  to  internal 
medication  in  the  treatment  of  a  num- 
ber of  acute  pathological  conditions  in 
veterinary  patients.  The  object  in 
adding  local  iodine  applications  to  the 
handling  of  such  conditions  is  varied. 
In  some  cases,  the  object  of  the  prac- 
titioner is  to  hasten  the  correction  of 
certain  well-marked  local  manifesta- 
tions of  the  disease  with  which  the  pati- 
ent is  afflicted.  In  other  instances,  the 
aim  of  the  practitioner  is  toward  the 
24 


prevention  of  these  local  manifesta- 
tions. Occasionally,  in  a  certain  type 
of  pathological  conditions,  the  prac- 
titioner intends,  by  the  use  of  topical 
iodine  applications,  to  enhance  the  in- 
ternal treatment  being  aimed  at  symp- 
toms whose  entire  nature  is  local  in 
character  and  confined  to  a  very  limited 
portion  of  the  anatomy. 

In  every  case  coming  under  this  sub- 
classification,  the  effect  that  the  iodine 
applications  have — the  only  effect  that 
they  are  able  to  accomplish — is  one  of 
amelioration;  they  can  have  no  direct 
curative  effect  here.  While  the  various 
conditions  that  are  included  under  this 
head  will  be  fully  discussed  in  follow- 
ing chapters,  I  will  point  to  the  use  of 
topical  iodine  medication  in  the  hand- 
ling of  a  case  of  parotitis  as  an  illus- 
tration. While  regional  applications  of 
iodine  are  the  rule,  in  the  handling  of 
cases  of  this  affection  in  veterinary 
25 


patients,  no  one  at  all  versed  in  the 
condition  as  it  occurs  in  practice  would 
give  the  credit  of  ultimate  cure  to  the 
iodine  applications.  But  all  will  admit 
readily  that,  while  the  internal  treat- 
ment indicated  by  the  pathology  of  the 
condition  is  correcting  the  lesion  per  sc, 
the  regional  applications  of  iodine  do 
contribute  materially  to  a  smooth 
termination  of  the  case  in  that  they  do, 
without  question,  lessen  the  possibility 
of  abscess  formation,  relieve  the  pain, 
and  hasten  resolution. 

The  conditions  included  under  this 
heading  form,  in  great  part,  that  class 
of  cases  to  which  reference  was  made 
in  the  beginning  of  this  treatise,  name- 
ly, those  in  which  iodine  treatment  is 
largely  used  under  circumstances  and 
in  conditions  that  lack  almost  every 
scientific  indication  for  its  application. 
Yet,  it  is  in  these  very  conditions,  and 
under  these  very  circumstances,  that 
26 


topical  applications  of  iodine  are  fre- 
quently most  salutary  in  effect.  And 
this  effect  is  enhanced  to  the  degree,  as 
will  be  pointed  out  later,  to  which  the 
practitioner  becomes  adept  in  the  selec- 
tion of  the  proper  form  or  preparation 
of  iodine  for  the  particular  case  in 
hand. 

3.  Regional  Iodine  Applications 
FOR  THE  Cure  of  Chronic  Patho- 
logical Conditions. 

It  is  in  the  correction  of  chronic 
pathological  conditions,  that  iodine 
therapy  finds  its  greatest  field  in  the 
practice  of  veterinary  medicine  and 
surgery.  It  is  in  chronic  pathological 
conditions,  that  iodine,  in  various 
forms,  and  with  various  modes  of  appli- 
cation, so  forcibly  demonstrates  its 
therapeutic  work,  for  it  is  here  that  io- 
dine is  often  the  only  agent  used  in  the 
27 


handling  of  the  case,  thus  constituting 
the  entire  treatment.  Under  these  cir- 
cumstances, it  is  never  a  difficult  matter 
to  decide  as  to  the  value  of  the  treat- 
ment or  the  activity  of  the  agent  used. 

Were  there  no  other  means  of  demon- 
strating the  fact  that  iodine,  in  some 
of  its  forms,  arouses  the  animal  organ- 
ism to  the  end,  and  in  the  direction,  of 
marked  efforts  at  regional  cure  of  vari- 
ous pathological  states,  we  would  have 
evidence  of  ample  weight  to  convince 
us  of  this  in  the  results  that  we  daily 
get  with  its  application  in  a  general 
practice. 

There  is  hardly  any  therapeutic  re- 
sult from  which  the  practising  veter- 
inarian derives  more  professional  sat- 
isfaction than  he  does  from  the  sure, 
gradual  effect  of  properly  selected  and 
correctly  applied  iodine  preparations  in 
chronic  pathological  conditions  of  the 
articulations,  from  the  speedy  and 
28 


specific  effect  of  others  in  certain  skin 
diseases,  and  from  the  almost  miracu- 
lous cure  of  certain  locaHzed  infections 
when  the  proper  iodine  medication  is 
appHed  in  these. 

So  sure  are  the  effects  of  iodine,  in 
a  curative  way,  in  certain  diseased  con- 
ditions among  domestic  animals,  that  it 
has  value  in  this  regard  from  a  diag- 
nostic standpoint.  Given  a  case  ap- 
parently of  this  type  for  handling,  the 
practitioner  can  be  assured  that  he  has 
erred  in  his  diagnosis  if  iodine,  in 
proper  preparation  and  correct  applica- 
tion, does  not  effect  a  cure.  To  illus- 
trate this,  I  need  only  refer  to  that  dis- 
eased condition  of  the  skin  commonly 
termed  "ring  worm." 

It  is  nothing  unusual,  in  a  veterinary 
practice,  to  see  the  curative  effects  of 
iodine  applications  demonstrated  in  cer- 
tain chronic  conditions,  of  the  articula- 
tions for  instance,  after  various  other 
29 


means  of  handling,  even  including 
surgical  interference,  had  failed  to 
effect  the  desired  result.  In  not  a  few 
of  such  conditions,  iodine  applications, 
in  some  form,  are  prescribed  as  a  sort 
of  ''last  resort"  treatment,  even  against 
the  hopes  of  either  client  or  practi- 
tioner, for  the  accomplishment  of  any- 
thing in  the  way  of  benefit. 

Almost  any  practitioner  of  veterinary 
medicine,  with  whom  you  may  care  to 
discuss  the  matter,  can  point  to  case 
after  case,  in  his  own  practice,  in  which 
a  spavin,  or  a  ring-bone,  that  had  been 
cauterized  or  otherwise  operated  upon 
with  failure,  had  yielded  to  a  course  of 
topical  iodine  applications.  In  some 
instances,  a  cure  of  this  sort  causes  a 
practitioner  to  lose  faith  in  operative 
measures  for  the  correction  of  the  con- 
ditions in  question.  Usually,  however, 
it  impresses  upon  him,  with  added 
force,  the  thought  that  he  has  not  fully 
30 


acquired  the  knack — either  along  prac- 
tical or  scientific  lines — to  select  his 
cases  properly.  Could  he  be  sure  that  a 
given  case  would  yield  to  applications 
of  iodine  preparations,  he  would  much 
prefer  to  treat  it  that  way;  but  he  is 
not  often  sure.  He  has  learned  that 
there  are  certain  cases,  although  to  all 
appearances,  as  far  as  he  is  able  to  tell, 
not  differing  from  other  cases  of  the 
same  nature,  will  yield  to  actual  cau- 
tery; he  has  learned,  also,  that  certain 
cases  will  yield  to  local  applications  of 
certain  iodine  preparations.  But  he 
finds  it  difficult  to  select  these  cases  for 
the  respective  forms  of  treatment  in 
the  general  run  of  his  practice.  That  he 
may  be  better  able  to  serve  his  clients, 
and  that  he  may  even  more  highly  ap- 
preciate the  therapeutic  worth  of  iodine 
in  some  of  its  forms  of  preparation,  I 
have  made  some  clinical  observations, 
in  my  own  practice,  which  I  shall  record 
31 


in  the  following-  chapters,  and  which,  I 
believe,  will  help  to  solve  this  problem 
for  him.  While  it  is  not  possible  to 
pick  out  every  case  in  which  iodine 
applications  will  give  the  desired  result, 
it  is  not  an  exceptionally  difficult  mat- 
ter to  select  the  great  majority.  It  is 
the  opinion  of  most  veterinary  prac- 
titioners, who  have  the  ethics  of  their 
profession  at  heart,  that  the  treatment 
of  certain  well-known  pathological  con- 
ditions of  the  articulations,  by  means 
of  the  actual  cautery,  is  one  of  the  most 
disagreeable  features  of  a  veterinary 
practice.  It  is  one  of  the  things  that 
most  veterinary  practitioners  are  trying 
to  get  away  from;  it  smacks  more  of 
quackery  and  dark-aged  farriery  than 
anything  else  that  the  veterinarian  is 
obliged  to  do.  When,  on  top  of  this, 
we  view  this  form  of  treatment  from 
the  angle  of  the  humanitarian,  we  fail 
to  understand  why  otherwise  able  and 
32 


enlightened  practitioners  will  resort  to 
it  under  any  conditions.  True,  there 
are  apparently  a  few  forms — a  very 
few — of  equine  lameness  that  will  yield 
to  no  other  form  of  treatment-  Note,  I 
have  said  apparently  there  are  some. 
I  believe,  in  fact,  that  any  case  of  lame- 
ness located  in  an  articulation  is  cur- 
able, if  it  is  curable  at  all,  by  means 
other  than  burning  the  area  with  a 
red-hot  iron.  While  most  of  us,  in 
practice,  do  fire  cases  of  articulation 
lameness,  I  believe  that  we  do  so  for 
the  reason  that  frequently  it  is  for  us 
the  easiest  way  to  terminate  the  con- 
ditions connected  with  the  case.  And 
I  further  believe  that  every  time  we 
resort  to  the  actual  cautery,  for  the  cor- 
rection of  a  lameness  in  an  articulation, 
we  admit,  in  the  fact  that  we  do  so 
resort,  that  we  do  not  fully  understand 

the  condition  we  are  attempting  to  cure. 
33 


This  belief  is  the  result  of  actual  con- 
tact with  ample  clinical  material  and 
the  observations  made  in  actual  prac- 
tice covering-,  a  period  of  time  extending 
over  more  than  fifteen  years. 

Other  chronic  pathological  condi- 
tions, in  which  iodine  applications  are 
frequently  serviceable,  are  various  new- 
growths  in  the  integument,  underlying 
tissues,  and  in  the  glandular  tissue  near 
the  body  surface.  It  is  often  possible 
to  accomplish,  with  topical  iodine  ap- 
plications, results  in  these  conditions 
which  could  only  be  equalled  by  surgi- 
cal interference  of  much  more  costly 
and  dangerous  character.  Iodine  ap- 
plications are  at  times  resorted  to  in 
such  conditions  as  these,  to  obviate  the 
scar  formation  that  might  result  from 
a  surgical  operation.  At  other  times, 
resort  is  had  to  iodine  on  account  of 
such  objections  to  surgical  interference 
34 


as  cost,  danger  to  the  patient's  life,  pro- 
tracted period  of  convalescence,  or  oth- 
er equally  reasonable  objections. 

In  the  effects  that  are  obtained  from 
the  local  applications  of  iodine  prep- 
arations, in  chronic  pathological  con- 
ditions, these  preparations  act  not  only 
in  a  palliative  or  ameliorative  sense, 
but  literally  in  a  curative  manner.  They 
accomplish,  in  these  conditions,  solely 
and  wholly  through  their  own  activity, 
the  removal  of  the  condition  and  the 
correction  of  the  respective  abnormali- 
ties. While,  in  some  of  the  conditions 
under  discussion,  the  desired  result  is 
attained  only  after  very  prolonged 
treatment  with  iodine,  the  condition  is 
usually  of  such  a  character  that  neither 
the  owner  of  the  animal  nor  the  at- 
tending veterinarian  is  averse  to  lend- 
ixig  the  time  consumed.  In  other  of 
these  conditions,  the  desired  result 
comes  very  promptly,  at  times  with  a 
35 


rapidity  that  causes  astonishment.  In 
all  cases  yielding  to  topical  iodine 
therapy,  sufficient  evidence  of  the  bene- 
ficial effect  derived  is  discernible  with 
sufficient  promptness  to  encourage  the 
continuance  of  the  treatment. 


36 


IV. 


The  Selection  of  Iodine  Preparations 
for  Practical  Use. 

Next  in  importance  to  the  proper 
selection  of  cases  amenable  to  topical 
iodine  application,  is  the  selection  of 
the  particular  preparation  of  iodine  to 
be  applied.  As  I  have  already  pointed 
out,  in  the  chapter  on  the  general  con- 
sideration of  local  iodine  therapy,  what 
may  be  an  indication  for  the  use  of 
iodine  in  one  form  may  lack  the  re- 
quisite pathological  status  for  its  suc- 
cessful application  in  another. 

While  the  effect  that  the  various 
preparations  produce  probably  does 
not  vary  to  a  great  extent,  the  ability 
to  exert  this  effect  does  vary  in  the 
different  preparations.  Because  of 
certain  physical  properties  with  which 
the  vehicle  carrying  the  iodine  is  en- 
Z7 


dowed,  certain  preparations  of  iodine 
are  more  active  in  a  given  condition 
than  others.  Others,  again,  hold  the 
iodine  in  such  a  manner  that  it  is  more 
readily  available  for  the  needs  of  the 
case  under  treatment,  while  yet  another 
preparation  may  hold,  within  its  phar- 
maceutical dress,  greater  quantities  of 
available  iodine  than  one  very  closely 
allied  to  it  in  every  other  regard. 

Then,  too,  it  is  not  always  the  par- 
ticular form  or  preparation  that  in- 
fluences the  effect;  frequently  this  in- 
fluence is,  for  the  most  part,  in  the 
pathological  condition  itself.  Without 
going  into  the  details  of  what  must  be 
especially  considered  in  the  selection  of 
the  preparation  to  be  used  in  a  given 
pathological  condition,  I  have  here  set 
down  the  observations  that  I  have 
made,  in  my  own  practice,  and  which 
my  experience  with  this  branch  of  vet- 
38 


erinary  practice  has  indicated  to  me  as 
being  as  nearly  correct  as  could  be  ex- 
pected in  a  practical  way. 

Tincture  of  Iodine. 

Skin  disinfection  in  Surgery. 

Skin  disinfection  previous  to  hypo- 
dermic injections. 

Adjunctive  to  systemic  medication 
in  the  treatment  of  generalized  in- 
fections with  local  manifestations, 
such  as  septicemia,  actinomycosis, 
acute  glandular  swellings  as  a 
complication  to  fevers,  parotitis, 
and  distemper. 

First  aid  application  for  sprains  of 
ligaments,  tendons,  and  bursae. 

First  aid  application  in  puncture 
wounds,  and  wounds  in  the  region 
of  the  hoof,  articulations,  and  bone 
bruises  and  contusions. 

Injection  into  abscess  cavities  after 
the  liberation  of  their  contents  by 
surgical  means. 
39 


Moist  parasitic  skin  diseases. 

As  an  adjunctive  in  all  conditions  of 
an  acute  character  in  which  it  is 
desired  to  enhance  the  action  of 
systemic  medication  aimed  at  the 
correction  of  local  manifestations. 

For  the  rapid  absorption  of  acute 
swellings,  such  as  sternal  cysts, 
cysts  in  the  fleshy  parts  from  kicks 
or  bruises. 

As  an  injection  into  the  synovial 
sack  of  enlarged  bursae,  after  the 
contents  have  been  drawn  off. 

Ointment  of  Iodine. 

Chronic  enlargements  of  the  articu- 
lations. 

Chronic  enlargements  of  osseous 
structures. 

Chronic  tumefactions  resulting  from 
specific  infection. 

Chronic  thickening  of  tendons. 

Chronic  thickening  of  ligaments. 

40 


Chronic  thickening  of  localized  areas 

in  the  skin. 

Inoperable  superficial  tumors,  when 
non-septic. 

Tumefactions  accompanying  chronic 
degenerative  processes,  such  as 
fistulae,  deep  sinuses,  and  ulcers. 

For  the  absorption  of  old  scar  tissue. 

As  a  hoof  dressing. 

Parasitic  skin  diseases. 

Herpes  tonsurans. 

As  a  packing  for  abscess  cavities, 
fistulae  and  sinuses. 

Mammitis. 

Orchitis. 

Chronic  arthritis,  spavin,  ringbone. 

Side-bone  lameness. 

Removal  of  splints,  curb,  buck  shin. 

Goiter. 

Ointments  of  iodine  are  especially 
serviceable  in  all  conditions  in  which 
it  is  desired  to  obtain  the  remote  ef- 
41 


fects  of  topical  iodine  medication, 
and  in  which  the  effect  desired  is  a 
gradual,  intensive  saturation  of  the 
parts  treated  with  the  iodine.  In 
choosing  an  iodine  ointment  for  this 
use,  the  veterinarian  should  select  a 
preparation  in  which  the  iodine  ex- 
ists free  and  uncombined  with  other 
agents,  in  a  vehicle  that  is  blandly 
penetrating  and  non-irritating.  I 
can  highly  recommend  lodex,  as  ful- 
filling exactly  these  requirements.  It 
can  be  applied  freely  and  indefinitely, 
and,  even  when  the  course  of  treat- 
ment is  exceptionally  prolonged,  the 
parts  to  which  it  is  being  applied 
show  no  sign  of  being  irritated. 
With  other  preparations,  it  is  often 
necessary  to  discontinue  the  applica- 
tions for  a  time  because  of  the  local 
irritating  effect.  This  delays  not 
only  the  ultimate  recovery  of  the  pa- 
tient, but  may  even  result  in  the  cure 
being  only  partly  satisfactory.  In 
addition  to  its  non-irritating  proper- 
ties, lodex  is  much  more  active  than 
any  other  ointment  preparation  of 
42 


iodine  with  which  I  am  acquainted, 
and  it  has  the  remarkably  note- 
worthy property  of  leaving  no  stains. 
Although  the  ointment  is  a  rich  blue- 
black  in  appearance,  it  may  be  ap- 
plied to  the  treated  area  with  the 
bare  hand,  and  will  not  stain  the 
fingers.  This  is  a  quality  not  pos- 
sessed by  any  other  active  iodine 
ointment  to  my  knowledge.  lodex 
can  be  obtained  from  all  large  whole- 
sale drug  houses  and  distributors  of 
veterinary  supplies.  It  is  a  Menley 
&  James  product.  Should  the  veteri- 
narian have  difficulty  in  obtaining 
lodex  from  his  regular  supply  house, 
I  would  advise  him,  rather  than  ac- 
cept a  substitute,  to  obtain  it  from 
them  direct,  by  writing  to  their  New 
York  Office  at  No.  i68  Duane  Street. 
I  have  used  many  iodine  prepara- 
tions in  my  practice  during  the  past 
fifteen  years,  and  have  found  in  lodex 
the  ideal  veterinary  iodine  ointment 
because,  as  I  have  already  pointed 
out,  the  iodine  in  it  appears  to  be  in  a 

free  state,  uncombined  with  detract- 
43 


ing  agents,  it  is  blandly  penetrating 
and,  therefore,  will  positively  not  ir- 
ritate the  most  tender  animal  skin, 
and  it  does  not  stain  the  hands  with 
which  it  is  applied. 

Comparing  its  properties  and  its 
marked  activity  with  that  of  other 
iodine  ointments,  it  is  by  far  the 
most  economical  for  the  veterinarian 
to  use. 

lodex  is  one  of  those  preparations, 
so  rare,  that  the  veterinarian  soon 
learns  to  appreciate  highly  and  with- 
out which  he  finds  it  difficult  to  con- 
duct his  practice,  once  he  has  made 
its  acquaintance.  He  finds  that 
there  are  so  many  conditions  in 
which  it  is  the  only  pharmaceutical 
article  that  exactly  fills  all  the  thera- 
peutic requirements,  and  he  is  able 
to  obtain  with  it  results  that  he  did 
not  think  possible  before  he  made  its 
acquaintance.  lodex  exceeds  in  ac- 
tivity the  other  iodine  preparations 
to  the  same  extent  that  an  autog- 
enous bacterin  exceeds  in  specifivity 
that  of  a  stock  bacterin,  and  I  would 
44 


advise  that  every  practitioner  of 
veterinary  medicine  who  has  not  yet 
made  its  acquaintance  write  at  once 
to  Menley  &  James,  No.  i68  Duane 
Street,  New  York  City,  for  a  trial 
package.  I  make  this  recommenda- 
tion with  a  full  realization  of  the  fact 
that  lodex  is  a  proprietary  agent, 
and  the  veterinarian  will,  in  the  light 
of  my  numerous  contributions  to 
ethical  veterinary  literature,  correct- 
ly infer  that  lodex  must  indeed  be 
an  agent  of  more  than  ordinary 
merit. 

Oily  Solutions  or  Mixtures  of 
Iodine 

Sub-acute  and  chronic  skin  lesions. 
Acute,  dry  skin  diseases. 

For  injection  into  synovial  bursae 

when    the    tincture    of    iodine    is 

contra-indicated. 
To  anoint  arms  and  hands   in  the 

handling  of  obstetrical  cases. 
For    direct    application    to    mucous 

membranes. 

45 


Ringworm. 

As  a  moist  dressing  for  wounds  of 
long  standing. 

Garget. 

Dry,  scaly  affections  of  hoofs  and  of 
the  legs  of  poultry. 

Open  joint. 

Injection  for  puncture  wounds. 

All  chronic  surface  conditions  in 
which  the  use  of  iodine  ointments 
would  not  be  practicable. 

Aqueous  Preparatons  of  Iodine. 

Although,  from  a  chemical  stand- 
point, the  mixture  of  tincture  of  io- 
dine with  water  would  be  considered 
wrong,  I  have  found  that  the  addi- 
tion of  one  dram  of  tincture  of  io- 
dine to  a  quart  of  sterile  water  makes 
a  most  satisfactory  combination  for 
use  in  veterinary  practice  for  a  num- 
ber of  diseased  conditions. 

In  mal-odorous  catarrhal  diseases, 
a  mixture  such  as  this  makes  a  fine 
wash. 

46 


In  the  treatment  of  foul-smelling  ul- 
cers and  fistulous  tracts,  it  should 
be  used  with  an  irrigator  after  the 
parts  have  been  cleaned  up  and 
just  before  the  usual  dressing  is 
applied. 

To  stimulate  the  process  of  healing  in 
wounds  and  lacerations  such  as 
barbed-wire  cuts  and  tears. 

As  a  moist  dressing  applied  on  gauze 
in  old  wounds. 

As  a  soaking  solution  for  foul-smell- 
ing hoof  troubles. 

As  a  wash  for  the  veterinarian's 
hands  and  arms,  to  prevent  infec- 
tion and  remove  odors,  after  the 
handling  of  after-births,  dead  fe- 
tuses, and  other  conditions  of  a 
similar  nature. 

When  this  preparation  is  used  at 
all,  it  should  be  applied  liberally;  it 
is  cheap  and  the  cost  need  never  be 
considered.  It  is  additionally  valu- 
able, in  a  veterinary  practice,  because 
it  can  be  made  up  extemporaneously 
47 


anywhere  that  water  can  be  obtained, 
as  all  veterinarians  carry,  in  their 
medicine  case,  a  supply  of  tincture  of 
iodine. 

The  strength  may  be  increased  if 
desired;  however,  I  have  found  the 
proportions,  as  given  above,  the  most 
satisfactory. 

In  my  experience,  I  have  found  that 
I  can  do  everything  that  it  is  possible 
to  do  with  iodine  preparations  by  using 
the  medicaments  already  indicated. 

However,  I  would  draw  the  prac- 
titioner's attention  to  that  preparation 
of  iodine  known  as  Lugol's  solution, 
because  there  is  one  condition  that  the 
veterinary  practitioner  comes  into  con- 
tact with  quite  frequently  in  which  this 
iodine  preparation  has  been  found  to 
give  some  very  good  results. 

Lugol's  solution  of  iodine  has  been 
found  to  act,  in  a  very  favorable  man- 
ner, in  certain  cases  of  periodic  ophthal- 
48 


mia  in  horses.  It  is  injected  hypo- 
dermically  in  the  region  of  the  fatty  pad 
just  over  the  affected  eye.  While  this 
is  not  truly  a  topical  application,  the 
effect  that  is  exerted  is  the  same  as 
that  resulting  from  repeated  inunctions 
of  other  active  iodine  preparations. 
The  use  of  Lugol's  solution,  in  this 
manner,  is  only  to  be  preferred  because 
it  accomplishes  the  desired  end  more 
rapidly,  and  with  less  expense  of  time, 
than  would  be  required  by  topical  ap- 
plications, frequently  repeated.  I  do 
not  doubt  that  just  as  good  and  lasting 
results  could  be  obtained,  in  this  con- 
dition, from  daily  inunction  of  the  in- 
dicated area  with  an  oily  iodine  pre- 
paration. 

It  remains  to  be  said  that,  in  this 
condition,  internal  medication  is  usually 
indicated  and  the  iodine,  in  any  form, 
applied  regionally,  merely  acts  adjunc- 
tively  in  any  case.  I  have  made  men- 
49 


tion  of  this  use  of  iodine  preparations 
because  some  practitioners  treat  per- 
iodic ophthalmia  in  this  manner  and 
have  claimed  good  results  repeatedly. 

Before  I  proceed  to  the  discussion  of 
the  special  application  of  iodine,  in  a 
number  of  pathological  conditions  in 
animals,  I  would  urge  the  veterinarian 
to  give  more  thought  to  the  forms  and 
preparations  of  iodine  of  which  he 
makes  use.  It  is  a  rather  common 
occurrence  that  a  practitioner  will 
allow  agents  of  well-known  therapeutic 
efficiency  to  be  displaced,  by  others  of 
doubtful  activity,  on  account  of  a  small 
difference  in  the  cost  of  the  same.  This 
is  especially  true  in  the  case  of  prep- 
arations in  which  the  active  ingredient, 
and,  therefore,  the  ingredient  to  be  de- 
pended upon  for  results,  is  iodine. 
Iodine,  to  begin  with,  as  an  elemental 
article,  is  costly.  The  veterinarian  may, 
therefore,  be  sure  that,  whenever  an 
50 


iodine  preparation,  of  a  certain  stated 
strength,  is  offered  for  sale  at  a  price 
considerably  lower  than  that  of  recog- 
nized preparations  of  a  similar  char- 
acter, the  lower  price  is  possible  only 
because  of  the  fact  that  the  iodine  con- 
tent is  not  as  represented. 

In  choosing  preparations  of  iodine, 
for  use  in  his  practice,  the  veterinarian 
can  easily  deprive  himself  of  much  of 
the  success  that  goes  with  correct  iodine 
therapy,  if  he  allows  his  choice  of 
preparations  to  be  influenced,  to  any 
great  extent,  by  the  cost  of  the  article. 

This  is  the  chief  reason,  and  there 
is  probably  no  other,  why  some  veteri- 
narians fail  to  get  satisfactory  results 
from  topical  iodine  applications.  They 
permit  their  better  judgment,  in  the 
selection  of  the  preparations,  to  be  in- 
fluenced too  markedly  by  price;  the 
preparation  that  they  select  fails  to  give 
the  expected  results  because  it  is  an 
51 


inferior  preparation,  either  in  the 
strength  or  the  quality  of  the  iodine  it 
is  said  to  carry.  Commonly,  both 
strength  and  quality  are  inferior. 

Well  made  and  honestly  prepared 
iodine  preparations  are  cheaper  than 
almost  anything  that  the  veterinarian 
uses,  in  a  pharmaceutical  way;  a  little 
of  a  good  iodine  preparation  "goes  a 
long  way" ;  and  it  accomplishes  what  it 
does  solely  through  the  exertion  of  its 
own  energy.  Almost  never,  it  might  be 
said,  are  other  agents  expected  to  assist 
it  in  its  action.  For  this  reason,  it  is 
very  essential  that  the  preparation  be 
of  correct  and  ample  strength,  that  it 
contain  the  iodine  in  a  form  readily 
available  by  the  tissues,  and  that  the 
vehicle  carrying  the  iodine  have  no 
detrimental  action  of  its  own. 

There  is  still  another  point  that  I 
wish  to  bring  out,  and  that  is  in  regard 
to  the  fee  that  the  practitioner  charges 
52 


for  the  handling  of  a  case  with  more 
or  less  costly  iodine  preparations. 
Usually,  his  fee  is  too  low.  The  prac- 
titioner should  consider  the  fact  that, 
in  not  a  few  of  the  cases  in  which  he 
uses  topical  iodine  treatment,  he  is 
actually  depriving  himself  of  a  surgical 
fee,  and  the  charge  that  he  makes  for 
the  treatment,  in  place  of  the  operation 
that  would  otherwise  be  required, 
should,  in  some  degree  at  least,  offset 
the  loss  thus  apparent.  In  some  cases, 
it  is  even  possible  to  get  a  larger  fee 
under  these  conditions,  for,  frequently, 
the  owner  of  an  animal  would  much 
prefer  that  a  given  condition  be  cured 
without  a  surgical  operation,  and  would 
offer  no  serious  objection  to  a  higher 
fee  for  the  correction  of  the  condition 
by  a  prolonged  course  of  topical  iodine 
medication.  In  the  case  of  a  valuable 
animal,  where  scar  formation  might 
depreciate  the  value,  the  smooth  results, 
53 


that  are  not  uncommonly  attained  with 
iodine  preparations,  actually  deserve  to 
be  rated  as  much  more  agreeable,  and, 
therefore,  worth  a  larger  fee,  than  a 
surgical  operation. 

Whenever  resort  is  had,  by  the 
veterinarian,  to  applications  of  iodine, 
in  considerable  amounts,  he  should  not 
hesitate  to  inform  the  client  that  the 
agent  used  is  costly,  and  that  a  special 
charge  will  be  made  therefor. 

Many  veterinary  practitioners  have 
come  into  the  habit  of  wTiting  prescrip- 
tions for  all  iodine  preparations  that 
they  find  it  necessary  to  use,  while  all 
other  medicines  they  dispense  out  of 
their  own  pharmacy.  I  do  not  consider 
this  good  practice,  for  several  reasons. 
The  main  fault  that  I  find  in  this  is  the 
one  making  it  possible  for  the  client  to 
have  the  prescription  refilled  without 
consulting  the  veterinarian.  It  is  noth- 
ing unusual  for  a  prescription  to  be 
54 


given  to  neighbors  or  relatives,  thus 
depriving  the  veterinarian  of  his  fee. 
Another  reason  that  I  have  for  finding 
fault  with  this  practice,  is  that  many 
druggists  will  not  fill  a  veterinary 
prescription  honestly;  seeing  that  it  is 
''only  for  a  horse"  or  a  cow,  they  do 
not  hesitate  to  use  drugs,  in  compound- 
ing the  prescription,  that  they  would 
not  think  of  putting  into  a  prescrip- 
tion for  a  human  being — old  drugs, 
drugs  of  inferior  quality,  and  the  like. 
For  these,  as  well  as  other  equally  im- 
portant reasons,  the  veterinarian  should 
dispense  all  iodine  preparations,  just 
as  he  does  all  others.  He  should 
not  be  deterred,  from  using  these 
preparations,  on  account  of  the  slightly 
higher  price  which  he  must  pay  for 
them,  if  he  makes  it  a  point  to  im- 
press the  worth  of  the  article  on  his 
client,  and  charges  the  fee  that  he 
should. 

55 


Method    of    Using    Regional    Iodine 

Therapy  in  the  Correction  of  Various 

Pathological  Conditions. 

If  the  reader  has  made  an  effort  to 
follow  me  in  what  I  have  said  in  the 
foregoing  chapters  of  this  treatise,  he 
will  have  no  difficulty  in  applying,  to 
cases  occurring  in  his  practice,  many  of 
the  suggestions  offered. 

In  this,  the  closing  chapter  of  the 
treatise  on  regional  iodine  therapy,  I 
intend  to  refer  to  a  small  number  of 
conditions,  in  the  handling  of  which  I 
have  found  great  satisfaction  in  the  use 
of  the  preparations  heretofore  men- 
tioned, and,  at  the  same  time,  I  shall 
endeavor  to  explain  my  own  particular 
methods  of  using  the  preparations. 

I  have  already  disposed  of  the  man- 
ner in  which  the  applications  of  tincture 
of  iodine  are  made,  previous  to  incision 
56 


of  the  integument,  in  surgical  opera- 
tions. Aside  from  this  quite  common 
use  of  this  preparation,  I  have  found 
tincture  of  iodine  of  great  worth  as  an 
appHcation  to  calk  wounds  in  the  coro^ 
nary  region  of  the  equine  foot.  When 
the  injured  horn  has  been  pared  away 
under  the  wound  in  the  coronary  band, 
and  the  loose  particles  of  flesh  and  hair 
cleaned  away,  the  wound  is  freely 
painted  with  pure  tincture  of  iodine. 
This  painting  is  to  be  repeated  several 
times  daily,  until  recovery  takes  place. 
Severe  infections  rarely  occur  if  the 
applications  are  begun  within  a  few 
hours  after  the  accident  occurs. 

Whenever  tincture  of  iodine  is  used, 
for  the  correction  of  an  abnormal- 
ity in  the  horse  and  cow,  it  must  be 
applied  very  liberally  if  the  effect  is 
desired  with  any  degree  of  promptness. 
This,  together  with  the  fact  that  the 
tincture  is  quite  irritating  to  the  skin 
57 


of  animals — a  fact  that  precludes  an 
extensive  course  of  treatment  with  this 
preparation — makes  iodine,  in  this  form, 
an  agent  that  is  chiefly  of  use  in  acute 
conditions,  and  it  is,  therefore,  the 
agent  of  choice  to  act  as  an  adjunctive 
treatment  to  the  internal  handling  of 
such  conditions  as  septicemia,  strangles, 
distemper,  parotitis,  lymphangitis  of  a 
localized  character,  and  acute  inflam- 
mations in  tendons,  ligaments,  and 
synovial  bursae.  In  any  of  these  con- 
ditions, it  is  best  applied  with  a  small, 
rather  stiff  brush,  painting  it  liberally, 
over  the  parts  involved,  several  times 
daily.  If  the  parts  become  very  much 
irritated  from  these  applications,  the 
treatment  must  be  stopped  and  the 
area  treated  with  a  coating  of  vaseline 
or  lard. 

The  oily  preparations  of  iodine  are 
especially  useful   in   various   skin   dis- 
eases,   ring-worm,    and    the    parasitic 
58 


form  of  scratches  in  horses.  The  secret, 
in  the  successful  handUng  of  these  con- 
ditions with  oily  preparations  of  iodine, 
lies  in  the  abstinence  from  water;  the 
parts  should  be  given  one  thorough 
washing,  when  treatment  is  first  begun, 
after  which  no  more  water  should  be 
applied.  If  the  parts  need  cleansing, 
while  the  course  of  treatment  is  under 
way,  it  should  be  done  in  a  dry  manner, 
with  clean  cloths  or  cotton  wads. 

Oily  preparations  of  iodine  may  also 
be  used  to  anoint  the  arms  of  the  sur- 
geon during  the  handling  of  infected 
cases  of  obstetrics.  Pouring  a  quantity 
of  the  preparation  into  the  palm  of 
the  hand,  and  then  rubbing  it  gently 
over  the  skin  of  both  hands  and  arms, 
proves  a  reliable  barrier  to  infection 
from  a  decomposed  fetus  or  after-birth. 

In  applying  the  oily  preparations  of 
iodine,  to  lesions  on  the  integument,  it 
is  always  necessary  to  massage  them 
59 


into  the  tissues  quite  vigorously;  when 
this  is  done  a  single  application  each 
day  suffices. 

Other  indications  for  the  oily  prep- 
arations, as  well  as  for  aqueous  prep- 
arations, of  iodine,  have  been  pointed 
out  in  the  chapter  devoted  to  the  selec- 
tion of  iodine  preparations  for  practical 
use. 

Ointments  of  iodine — which,  for  me, 
mean  lodex — have,  by  far,  the  most 
extensive  field  of  application,  and  the 
uses  to  which  an  iodine  ointment  may 
be  put  have  already  been  quite  clearly 
indicated.  I  will,  however,  remark 
some  of  the  points  to  be  considered  in 
using  lodex  in  such  cases  as  spavin 
lameness  and  similar  affections  of  the 
articulations. 

In  choosing,  for  treatment  with  lodex, 
a  case  of  spavin  lameness,  the  practi- 
tioner should  select  only  those  cases  in 
60 


which  the  horse  warms  out  of  the  lame- 
ness; these  cases  can  positively  be  cured 
by  lodex  applications.  Do  not  at- 
tempt to  cure  the  lameness  caused  by 
spavin  in  which  the  horse  will  not  warm 
out  of  the  lameness;  these  cases  are  not 
only  impossible  of  cure  by  this  means 
but  by  other  means,  excepting  neurec- 
tomy, as  well. 

When  the  case  has  been  selected,  the 
lodex  should  be  applied,  not  only  in 
the  immediate  vicinity  of  the  exostosis, 
ibut  entirely  around  the  hock  involved. 
An  application  should  be  made  every 
morning  and  every  evening,  in  the  fol- 
lowing manner :  Apply  a  thin  coating 
of  lodex  and  massage  it  into  the  hock 
for  at  least  five  minutes ;  then  apply  an- 
other very  thin  coating,  allowing  this 
to  remain  on  the  surface.  The  appli- 
cations must  extend  over  a  period  of 
from  five  to  seven  weeks — about  such 
a  length  of  time  as  is  required  to  effect 
61 


a  cure  with  actual  cautery — and,  during 
the  first  few  weeks  of  this  period,  the 
animal  should  be  at  rest.  After  the 
second  week,  it  may  indulge  in  light 
exercise  in  a  lot  or  paddock,  but  may 
not  be  worked. 

Cases  of  spavin,  treated  in  this  man- 
ner— cases  selected  for  treatment  as 
above  outlined — are  not  only  cured  of 
lameness,  but,  in  many  cases,  the  en- 
largement also  disappears. 

The  same  results  are  obtained  in 
cases  of  lameness  from  ringbone,  side- 
bone,  splint  and  curb. 

Buck  shins  can  be  entirely  absorbed 
with  applications  of  lodex  as  directed 
above. 

Other  conditions,  in  which  the  effects 
of  lodex  frequently  are  most  remark- 
ably   satisfactory,    are    goitre,    fibrous 
tumors  on  the  body  surface,  hygroma, 
62 


and    tendonous    and    ligamentous    en- 
largements. 

The  applications,  in  these  conditions, 
are  made  in  a  manner  similar  to  that  in 
spavin,  massaging  the  lodex  thorough- 
ly into  the  parts  involved. 

In  bringing  this  treatise  to  an  end, 
I  would  again  urge  the  practitioner  to 
add  lodex  to  his  therapeutic  armament, 
and  use  it  not  only  in  the  conditions  of 
which  I  have  here  made  mention,  but 
in  many  other  indications  for  iodine 
therapy  which  come  up  almost  daily  in 
every  veterinary  practice. 


63 


